Nijhawan Rajiv I, Jacob Sharon E, Woolery-Lloyd Heather
Department of Dermatology and Cutaneous Surgery at University of Miami Miller School of Medicine, Miami, Florida 33125, USA.
J Am Acad Dermatol. 2008 Oct;59(4):615-8. doi: 10.1016/j.jaad.2008.06.024. Epub 2008 Jul 25.
It is projected that by the year 2050, close to 50% of the US population will comprise people with skin of color.
We sought to assess whether future dermatologists will be prepared to treat patients with skin of color.
An e-mail with a link to a brief 9-question survey was sent to 109 program directors and chief residents.
A total of 41 (37.6%) program directors and 63 (50.0%) chief residents completed the online survey. In all, 14.3% (P<.001) of chief residents and 14.6% (P<.001) of program directors recognized an expert at their institutions who conducted a skin of color clinic. In all, 25.4% (P<.001) of chief residents and 19.5% (P<.001) of program directors reported having lectures on skin of color from an acknowledged expert. In all, 30.2% (P<.001) of chief residents and 12.2% (P<.001) of program directors reported a specific rotation in which residents gained specific experience in treating patients with skin of color. In all, 52.4% (P=.70) of chief residents and 65.9% (P<.02) of program directors reported to have either lectures or didactic sessions focusing on diseases in skin of color incorporated into their curriculums. In all, 84.1% (P<.001) of chief residents and 90.2% (P<.001) of program directors reported having training programs in which residents gained experience treating patients with central centrifugal cicatricial alopecia. In all, 100% (P<.001) of both chief residents and program directors reported having training programs in which residents gained experience treating patients with keloids and melasma.
The limitations of this study included recall bias, an incomplete response rate, unsure respondents, and questions that may not have applied to certain programs.
The results indicate a need for increased exposure, educational sessions, and overall training in diseases pertaining to skin of color in US dermatology residencies.
预计到2050年，近50%的美国人口将是有色人种。
我们试图评估未来的皮肤科医生是否准备好治疗有色人种患者。
向109名项目主任和总住院医师发送了一封电子邮件，其中包含一个指向简短的9个问题调查问卷的链接。
共有41名（37.6%）项目主任和63名（50.0%）总住院医师完成了在线调查。总体而言，14.3%（P<0.001）的总住院医师和14.6%（P<0.001）的项目主任认可他们所在机构有一位开设了有色人种皮肤诊所的专家。总体而言，25.4%（P<0.001）的总住院医师和19.5%（P<0.001）的项目主任报告有来自公认专家的关于有色人种皮肤的讲座。总体而言，30.2%（P<0.001）的总住院医师和12.2%（P<0.001）的项目主任报告有一个特定的轮转，住院医师在其中获得了治疗有色人种患者的特定经验。总体而言，52.4%（P=0.70）的总住院医师和65.9%（P<0.02）的项目主任报告其课程中纳入了专注于有色人种皮肤疾病的讲座或教学课程。总体而言，84.1%（P<0.001）的总住院医师和90.2%（P<0.001）的项目主任报告有培训项目，住院医师在其中获得了治疗中心离心性瘢痕性秃发患者的经验。总体而言，100%（P<0.001）的总住院医师和项目主任都报告有培训项目，住院医师在其中获得了治疗瘢痕疙瘩和黄褐斑患者的经验。
本研究的局限性包括回忆偏倚、不完整的回复率、不确定的受访者以及可能不适用于某些项目的问题。
结果表明，在美国皮肤科住院医师培训中，需要增加对与有色人种皮肤相关疾病的接触、教育课程和整体培训。
